Warren, Zakery R

Warren, Zakery R is an individual health care provider with primary practice located at 2705 E 17Th St Ste A , Ammon ID 83406-6601. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Mental Health is his primary health care specialty. Warren, Zakery R can be contacted via phone (208) 346-7500.

Contact Information

Primary practice address
2705 E 17Th St Ste A Ammon ID 83406-6601
Phone: (208) 346-7500
Fax: (208) 346-7501
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X 4472 Idaho
Behavioral Health & Social Service Providers / Clinical 1041C0700X LPC3960 Idaho

Profile Details

NPI number 1053597344
LBN Legal business name Warren, Zakery R
Credentials LCPC4472
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 16th, 2008
Last updated Feb 15th, 2019 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1053597344 NPPES
Idaho MEDICAID 002648300

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